# SPARKS CLINIC P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215124276
- **Authorized official:** DR. JOHN ROBERT SPARKS D.O. (PHYSICIAN)
- **Authorized official phone:** (660) 665-1400

## Contact information

- **Practice address:** 1410 CROWN DR, KIRKSVILLE, MO 63501-2548
- **Practice address phone:** (660) 665-1400
- **Practice address fax:** (660) 665-2081
- **Mailing address:** 1410 CROWN DR, PO BOX 703, KIRKSVILLE, MO 63501-2548
- **Mailing address phone:** (660) 665-1400
- **Mailing address fax:** (660) 665-2081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R5954 | MO | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 11/16/2007